Infection Control Matters

VAP in the ’too difficult’ box - could VAE be the answer? with Dr Michael Klompas

In this week's episode, Martin talks to Dr Michael Klompas, Infectious Disease physician, Hospital Epidemiologist, and Professor of Population Medicine at Harvard Medical School and Brigham and Women's Hospital, Boston, USA. We discuss the complexities of undertaking surveillance of Ventilator-associated pneumonia (VAP) and the USA approach to looking at the wider issue of Ventilator-associated Events (VAE) that removes subjectivity from the surveillance of these important complications. We also discuss the recent SHEA/IDSA/APIC/AMA prevention strategies paper that is the latest state of the art guidance on VAP/VAE prevention.
Useful reading here:
1. Klompas M, et al. Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol. 2022;43(6):687-713.  https://doi.org/10.1017/ice.2022.88
2. Weinberger JF, et al. Changes in the epidemiology of ventilator-associated events over the course of the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol. 2021:1-3. https://doi.org/10.1017/ice.2021.459
3. Klompas M. Ventilator-Associated Events: What They Are and What They Are Not. Respir Care. 2019;64(8):953-961.  https://doi.org/10.4187/respcare.07059
4. Klompas M. Ventilator-associated conditions versus ventilator-associated pneumonia: different by design. Curr Infect Dis Rep. 2014;16(10):430.  https://doi.org/10.1007/s11908-014-0430-0
5. Klompas M, et al. Risk of misleading ventilator-associated pneumonia rates with use of standard clinical and microbiological criteria. Clin Infect Dis. 2008;46(9):1443-1446.  https://doi.org/10.1086/587103

Hidden reservoirs contribute to plasmid-mediated transmission with Dr Kalisvar Marimuthu

In this week's episode, Brett and Martin talk to Adjunct Assistant Prof Dr Kalisvar Marimuthu, who is currently a senior consultant in Infectious Diseases at the National Centre for Infectious Diseases and Tan Tock Seng Hospital, Singapore. We discuss his recent paper that notes that over 50% of transmissions occurring in healthcare result from plasmid and not colonal spread. Traditional IPC interventions seem to work for clonal transmission, however new thinking is required to tackle the problems of plasmids.
Papers we discuss are:
1. Marimuthu K, Venkatachalam I, Koh V et al. Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales. Nat Commun 2022; 13: 3052. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160272/ 2. Ng DHL, Marimuthu K, Lee JJ et al. Environmental colonization and onward clonal transmission of carbapenem-resistant Acinetobacter baumannii (CRAB) in a medical intensive care unit: the case for environmental hygiene. Antimicrob Resist Infect Control 2018; 7: 51. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-018-0343-z
 

Glove or no glove - with Dr Jon Otter

In this week's episode, Brett and Martin caught up with Jon Otter to discuss the 'Glove or no glove' campaign currently being implemented at Guy's and St Thomas' Hospitals in London UK. Jon has recently blogged about this (https://reflectionsipc.com/2022/05/04/we-need-to-talk-about-gloves/), a blog always worth following if you like to read Jon's thoughts and musings on current issues in IPC.

Turning prevalence into incidence to determine the burden of healthcare associated infections

In this week's episode, Martin Kiernan talks to Brett Mitchell about his recent paper that estimates the burden of HCAI from a prevalence study.
Papers discussed are:
Lydeamore MJ, Mitchell BG, Bucknall T, Cheng AC, Russo PL, Stewardson AJ Burden of five healthcare associated infections in Australia. Antimicrob Resist Infect Control 2022; 11: 69. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01109-8
Russo PL, Stewardson AJ, Cheng AC, Bucknall T, Mitchell BG The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrob Resist Infect Control 2019; 8: 114. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0570-y

Are we experts? Phil, Brett and Martin mull this over

This week's podcast is a live chat recorded in Melbourne in June and features Phil Russo, Brett Mitchell and Martin Kiernan, who discuss whether we think that we are IPC experts (or not). Have a listen and make your own mind up!

Arrival of Monkeypox and will transmission paradigms change post-COVID? With Dr Deb Friedman

A/Professor Deb Friedman is the Deputy Chief Health Officer at the Department of Health Victoria,  Australia. Prior to that she was the Medical Director of infection prevention control and response in Victoria, a key role in Victorias covid response. With an extensive history in infection prevention and control as an infectious diseases  physician Deb has played a vital role in Victoria's COVID response. In this episode, Phil Russo chats to her about her role as DCHO and her recent involvement with the arrival of monkey pox.  With her great insight Deb also shares her  views about the airborne v droplet paradigm.

The New Zealand National Point Prevalance Study with Dr Sally Roberts

In this podcast Phil Russo chats with Dr Sally Roberts, Clinical Head of Microbiology at the Auckland District Health Board, Aotearoa New Zealand. She is also the National Clinical Lead  for the Health Quality & Safety Commission New Zealand Infection Prevention and Control programme and recently led the recent first national point prevalent survey of healthcare associated infections across Aotearoa New Zealand. Sally tells us what led to the first ever PPS in Aotearoa New Zealand, the many challenges they endured, the major findings and how the data will be used nationally. A publication is in the making, in the meantime you can read the full Aotearoa New Zealand Health Safety and Quality report here.

I-DECIDED tool

In this podcast, Brett talks to Dr Gillian Ray-Barruel from the University of Queensland and Griffith University. We talk about Gillian's development of the I-DECIDED tool - decision tool for assessment and management of all invasive devices in the hospital setting.
In the podcast, Gillian mentioned she was happy to be contacted.
The link to the paper can be found here: https://pubmed.ncbi.nlm.nih.gov/35439078/
 

Using whole genome sequencing as part of an infection control service

In this podcast, Martin and Brett talk to Trish Hurst, Belinda Henderson and Dr Patrick Harris about how WGS is being used in two major Australian hospitals. We here about how it started, how is works now and the potential of WGS in real-time for infection control services.
The discussion is centred around this pre-print publication: https://www.medrxiv.org/content/10.1101/2022.05.02.22273921v1 "Clinical implementation of routine whole-genome sequencing for hospital infection control of multi-drug resistant pathogens"

What affects environmental contamination with C. difficile? New papers with Dr David Weber

In this week's episode, Martin Kiernan talks to Dr David Weber, Professor of Medicine, Pediatrics and Epidemiology at the University of North Carolina about recent papers on environmental contamination with Clostridioides difficile. We discuss antibiotics and the effect of asymptomatic carriage on risk of transmission. The papers we discuss are:
Warren BG, et al. The Impact of Infection Versus Colonization on Clostridioides difficile Environmental Contamination in Hospitalized Patients With Diarrhea. Open Forum Infect Dis. 2022;9(4):ofac069.  https://doi:10.1093/ofid/ofac069
Turner NA, et al. Impact of Oral Metronidazole, Vancomycin, and Fidaxomicin on Host Shedding and Environmental Contamination With Clostridioides difficile. Clin Infect Dis. 2022;74(4):648-656.  https://doi:10.1093/cid/ciab473